How Does the Ionising Radiations Regulations 2017 Relate to Health and Social Care?

The Ionising Radiations Regulations 2017 (IRR17) is a piece of legislation designed to protect workers, patients, and the public from the potential risks associated with exposure to ionising radiation. This is particularly relevant in health and social care, where many diagnostic and therapeutic procedures involve the use of radiation. This regulation sets legal duties for employers and workers to mitigate risks and ensure safety when radiation is used. In this guide, we will look at how this legislation relates to health and social care.

What Is Ionising Radiation?

Ionising radiation is a form of energy released by atoms in the form of electromagnetic waves or particles. It has enough energy to remove tightly bound electrons from atoms, creating ions. Common types of ionising radiation include X-rays, gamma rays, and particles like alpha and beta radiation.

In health care, X-rays are frequently used for diagnosis (e.g., chest X-rays or CT scans), and radiotherapy uses radiation to treat cancers. These technologies can lead to ionising radiation exposure for both patients and staff.

Who Is Affected in Health and Social Care?

Health care workers who regularly work with radiation equipment, such as radiographers, dentists, oncologists, and surgeons, are directly affected by IRR17. The regulation also protects ancillary staff, like porters or cleaners who may work in areas where radiation is present.

Patients receiving medical tests or treatments involving radiation are indirectly protected by this regulation, as it aims to ensure that procedures are performed as safely as possible. Administrative staff in health and social care settings may also be affected if they handle radiation-related processes or records.

Key Provisions of IRR17

The main requirements of the Ionising Radiations Regulations 2017 and their connection to health and social care include the following:

Risk Assessment

• Employers must identify risks linked to ionising radiation and develop measures to reduce or eliminate exposure.
• In health care, this means assessing the use of machines such as X-ray or CT scanners to ensure that they are safe for workers and patients.
• Risk assessments must be reviewed regularly to address changes in procedures, equipment, or staffing.

Radiation Protection Advisor (RPA)

• Employers need to appoint an RPA to provide up-to-date advice on radiation protection.
• In the NHS or private medical settings, this might involve consultation with a medical physicist who can help ensure compliance with radiation safety protocols.

Controlled and Supervised Areas

• Work areas where radiation exposure exceeds a certain level must be classified as controlled or supervised areas.
• Examples in health care include locations where X-ray machines, CT scanners, or radiotherapy equipment are operated.
• Access to these areas must be restricted to authorised individuals, and safety measures must be in place, such as warning signs and protective barriers.

Monitoring Exposure

• Radiation exposure for workers must be monitored and recorded.
• Wearable devices, like dosimeters, are used in hospitals to measure the radiation dose received by staff.
• Records must be kept for at least two years to ensure long-term tracking and management.

Training

• Workers who may be exposed to radiation should be trained to understand the risks and follow safety procedures.
• Radiographers and other health care staff must know how to operate radiation equipment safely, while others, such as cleaners, need to understand how to avoid exposure in restricted areas.

Dose Limits

• IRR17 establishes exposure limits for individuals to minimise health impacts.
• For general workers, the annual dose must not exceed 20 millisieverts (mSv). For the public, the dose should be even lower at 1 mSv per year.
• These limits guide hospitals and clinics to adopt best practices to reduce unnecessary exposure.

Radiation Protection Supervisor

• Employers must appoint a Radiation Protection Supervisor (RPS) locally to oversee day-to-day safety.
• For example, a lead radiographer may act as the RPS, ensuring on-the-ground compliance in a hospital’s imaging department.

Prior Authorisation

• High-risk equipment requires authorisation from the Health and Safety Executive (HSE) before use.
• In health care, this means that only properly tested and approved machines, such as CT scanners, can be employed in patient care.

Impact on Health Care Workers

One of the primary goals of IRR17 is to prevent health care workers from being exposed to unsafe levels of ionising radiation. If hospitals fail to comply with controls, radiographers, surgeons performing fluoroscopy, or oncologists delivering radiotherapy may face unnecessary health risks.

The risks of prolonged or high-level exposure include:

• Increased likelihood of cancer.
• Potential harm to fertility or unborn children in pregnant workers.
• Long-term health conditions like cataracts.

IRR17 aims to mitigate these risks by ensuring that:

• Procedures limit exposure time.
• Equipment is regularly maintained and calibrated.
• Appropriate protective clothing, like lead aprons and gloves, is always used.

Impact on Patients

Patients benefit indirectly from the Ionising Radiations Regulations 2017. Although they are not considered workers, IRR17 ensures that all procedures carried out in medical settings reduce unnecessary exposure.

Patients undergoing diagnostics, such as X-rays or mammograms, or treatment involving radiation, are often concerned about the risks. IRR17 includes measures like:

• Using the lowest dose possible while still achieving quality results.
• Shielding parts of the body not being examined or treated.
• Monitoring patient doses to avoid excessive use over time.

Balancing Risks and Benefits

Radiation can pose risks, but it also has clear benefits in diagnosing and treating illness. To balance these, IRR17 encourages employers in health and social care to keep radiation exposure “as low as reasonably practicable” (this is referred to as the ALARP principle). This means:

• Only performing X-rays or scans when there is a clear medical necessity.
• Exploring non-radiation alternatives where feasible, such as ultrasound or MRI.

Employers must also justify every use of ionising radiation by showing that it provides a necessary health benefit to patients.

Application in Dental Practices

Dentists use X-rays for tasks like detecting cavities or assessing jaw alignment. IRR17 applies here by requiring safe practices in dental surgeries. This might involve:

• Using modern digital X-ray equipment that reduces radiation doses.
• Providing protective aprons for patients.
• Keeping a safe distance or staying behind lead barriers when taking X-rays.

Safeguarding Pregnant Workers

The regulations include specific guidelines for pregnant employees. If a health care worker informs their employer of a pregnancy, steps must be taken to monitor and limit workplace exposure to ionising radiation.

Employers:

• Must ensure that the radiation dose to the foetus does not exceed 1 mSv during the pregnancy.
• Might reassign duties for pregnant workers to roles that minimise or eliminate radiation risks.

Accountability and Inspections

The Health and Safety Executive (HSE) enforces IRR17. In health and social care settings, safety inspections may take place to assess compliance.

Non-compliance can lead to:

• Enforcement actions, like improvement notices.
• Penalties or fines.
• Reputational damage for the health care provider.

Best Practices in Health and Social Care

Health and social care providers can stay compliant by adopting these practices:

• Regular Training: Help staff keep up-to-date with safety measures.
• Equipment Maintenance: Schedule regular checks to ensure equipment is functioning properly.
• Transparent Policies: Share relevant policy updates with all staff, not just those working directly with radiation.
• Incident Reporting: Develop clear procedures for addressing and reporting any incidents of overexposure.

Conclusion

The Ionising Radiations Regulations 2017 has a direct impact on health and social care. It protects workers who regularly come into contact with radiation and ensures safer practices for patients receiving diagnostic or therapeutic procedures. By following the regulation, health care facilities can reduce the risks associated with radiation exposure. This creates a safer workplace for employees and increases public trust in medical care.